Percutaneous Coronary Intervention Clinical Trial
Official title:
Predictive Value of HAS-BLED and CHA2DS2-Vasc Scores for Clinical Outcome After PCI
To assess the predictive value of two scoring systems, namely HAS-BLED and CHA2DS2-VASc scores, to be linked with bleeding events and recurrence of chest pain and other measures of clinical outcome of percutaneous coronary intervention. The investigators aim to provide evidence for local guidelines of optimum options suited to our population
Dual-antiplatelet therapy (DAPT) with aspirin and an inhibitor of the platelet P2Y12 receptor
is necessary to prevent stent-related thrombotic complications after percutaneous coronary
intervention (PCI). (1) Although continuation of DAPT confers substantial and durable
benefits that extend beyond the local stented segment, bleeding risk also increases with
continued exposure to antiplatelet therapy. (2) Current guidelines give fixed duration of
DAPT after coronary intervention but many patients still having early stent thrombosis
despite this fixed policy, while others, on the contrary, suffer minor and major bleeding
events. These clinical situations should raise the possibility of individualizing therapy.
(5) The rationale of this study is to find a new method to tailor the optimal duration of
DAPT for each patient by balancing long-term risks for both coronary thrombosis and major
bleeding (MB).
The HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or
predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly)
score has long been used to predict bleeding events in patients on anticoagulation therapy.
(3) Also, the CHA2DS2-VASc (congestive heart failure, hypertension, ≥75 years, diabetes,
stroke/transient ischemic attack or thromboembolism, vascular disease, elderly, sex) score is
a well-established system for prediction of thrombo-embolic events in patients with atrial
fibrillation. (4) The aim of the present study is to evaluate the predictive ability of these
2 scoring tools when applied to patients undergoing PCI.
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